Lantus - decreasing rapidly

Had to increase my lantus/BI in October due to lots of high (teens/20's/30's) BS levels.
During November have had to keep decreasing due to lots of hypos - how much longer can this carry on? At this rate I'll be taking no BI - frightening.com!

Oct
26u BI
8th 28u - increased
17th 30u
23rd 36u

Nov
1st 40u
2nd new BI pen?
5th 42u
12th 36u - decreased
19th 34u
20th 32u
23rd 30u
26th 26u
30th 22u

Dec
4th 18u - still waking up to hypos so guess I'll have to decrease again!

I am going through similar changes to you, although I haven't had to drop as many as you, maybe 11 units dropped over the AM and PM BI dose...

It could be seasonal changes that are contributing. I thought BI would go up in winter though due to your body working harder behind the scenes to keep warm. But its not working out that way for me. I maybe thought activity levels were also contributing, but again, as the winter approached my levels decreased as I favored staying in the house to going out to exercise.....

So I am at a loss. It just has to be put down to changes that are unexplained..........

The good thing is your insulin levels are dropping, it may seem scary, but in the long term its good.......

Are you woken in the night with lows or is it just the morning when you normally wake.......?

Has your daytime levels been effected with the reduction of BI?

novorapidboi26 said:
I am going through similar changes to you, although I haven't had to drop as many as you, maybe 11 units dropped over the AM and PM BI dose...

It could be seasonal changes that are contributing. I thought BI would go up in winter though due to your body working harder behind the scenes to keep warm. But its not working out that way for me. I maybe thought activity levels were also contributing, but again, as the winter approached my levels decreased as I favored staying in the house to going out to exercise.....

So I am at a loss. It just has to be put down to changes that are unexplained..........

The good thing is your insulin levels are dropping, it may seem scary, but in the long term its good.......

Are you woken in the night with lows or is it just the morning when you normally wake.......?

Has your daytime levels been effected with the reduction of BI?

Just keep going until your blood sugar is held steady.....that the DAFNE approach........

have you tried splitting your dose so that you have some bi in in the morning to combat the higher levels and some in the evening to stop the lower levels try having half in am and half pm

If you are going to split doses, you will want to talk to your DAFNE coordinator as there is a process to do that gradually. I'm thinking of doing the same, but it isn't just a case of doing half and half as that could lead to some unpredictable BG readings.

My regular BI is 24 Lantus, but I often drop it down to 18 if I am going to have a high activity day the following day. I know of other DAFNE grads on less BI, so don't worry too much. Certainly getting the Basal correct is the most important, and it appears that you are getting close to that. You can then review your QA ratios and see if they need increasing.

All the best with it.

Warwick.

Warwick,

Dropping your Lantus for the following day theoretically shouldn't have an effect as it takes a few days for the dose change to settle in.....

How intense would the activity be and how has your decrease of dose worked out.....?

Have you thought about changing to Levemir? This is licensed to be injected twice a day. Lantus is not. It has a 24hr (ish) profile so arguably you could end up having more hypos after taking a dose, as you would still have the previous injection in your system (possibly peaking). Any changes with Lantus need to be monitored over 2/3 days before the next change is made.

Looking at your BG readings - Are you definately a 1u:1CP for all meals? You may wish to consider changing your ratios. My experience is that I am more resistant at breakfast (and dawn phenomenon to boot) and I have to take 2u:1CP but at e/meal I can drop that to 1u:1CP.

Are you counting ALL CPs? I thought I was however, when I was testing and getting BGs of 12.3 I decided to start calculating EVERYTHING - sauces, gravy, vegetables..... etc, they all contain a little bit of carb and add up. It helped me.

I hope you manage to sort it out. I know how frustrating it is when you think you have 'nailed' it and then you test

Hi novorapidboi26 ,

I cycle one hour to work and one hour back, and play basketball on Fridays, but weekends are the killer, looking after my 2 year old daughter :-)

Reducing basal does help. I am also experimenting with legumes such as baked beans for breakfast as they release sugar slowly, and having some success with that.

Cheers,
Warwick.